BMC Anesthesiology最新文献

{"title":"Impact of arm position compared to tourniquet and general anesthesia on peripheral vein width in supine adult patients: a prospective, monocentric, cross-sectional study.","authors":"Christian Berger, Philipp Brandhorst, Elena Asen, Sven Grallert, Sascha Treskatsch, Moritz Weigeldt","doi":"10.1186/s12871-024-02765-6","DOIUrl":"10.1186/s12871-024-02765-6","url":null,"abstract":"<p><strong>Background: </strong>IV access is a commonly performed procedure that is often taught based on tradition rather than evidence. The effect of arm retroflexion on vein width, either alone or in combination with a tourniquet or general anesthesia (GA), remains unclear. In this case, the sonographically measured vein width is a surrogate parameter for the success of the puncture.</p><p><strong>Methods: </strong>Prospective, cross-sectional study involving 57 patients scheduled for surgery in general anesthesia. We analyzed the impact of arm retroflexion, tourniquet, general anesthesia, and their combinations on the antebrachial veins in supine patients by ultrasound. Measurements were taken awake and during general anesthesia, each with and without the application of a tourniquet, and in three different arm positions (0°, 30°, and max° retroflexion) each. Data are presented as median and interquartile range [IQR].</p><p><strong>Results: </strong>Tourniquet application (AT) had the greatest single effect on Cubital vein outer diameter compared to the baseline value of all measures (3.9 mm [3.4-5.1]; 4.8 mm [4.1-5.7], P = 0.001, r = 0.515). This effect was surpassed by the combination of AT and GA (5.1 mm [4.6-6.6], P = 0.001, r = 0.889). In contrast, retroflexion alone did not result in an increase at either 30° (4.2 mm [3.7-5.1], p = 1.0, r = 0.12) or max° (4.2 mm [3.6-4.9], p = 0.72, r = 0.23). With GA and AT, no further enlargement was measurable by 30° (5.4 mm [4.6-6.6], p = 1.0, r = 0.15) or max° (5.4 mm [4.6-6.6], p = 1.0, r = 0.07) retroflexion compared to GA-AT-0° (5.1 mm [4.6-6.6], p = 1.0, r = 0.15).</p><p><strong>Conclusions: </strong>This study provides evidence that retroflexion of the arm in supine patients, whether alone or in addition to a tourniquet or general anesthesia, does not have any additional effect on vein width as a surrogate parameter for successful IV success. It shows for the first time that general anesthesia effectively increases vein diameter.</p><p><strong>Trial registration: </strong>DRKS00029603 (date of registration 07.07.2022).</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"379"},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11494795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of epidural ropivacaine versus levobupivacaine for labor analgesia on maternal and fetal outcomes: a meta-analysis.","authors":"Zhen Li, Xinxing Zhou, Hailin Wang","doi":"10.1186/s12871-024-02767-4","DOIUrl":"10.1186/s12871-024-02767-4","url":null,"abstract":"<p><strong>Introduction: </strong>Newer neuraxial local anesthetic agents which have been used as epidural analgesia have shown to provide reliable pain relief during labor. Ropivacaine and levobupivacaine are newer agents now used for labor analgesia. However, even though few studies have made their comparison with bupivacaine, ropivacaine and levobupivacaine have seldom systematically been compared. Therefore, in this analysis, we aimed to systematically show the impact of epidural ropivacaine versus levobupivacaine for labor analgesia on maternal and fetal outcomes.</p><p><strong>Methods: </strong>http://www.</p><p><strong>Clinicaltrials: </strong>gov , Web of Science, MEDLINE, EMBASE, Cochrane database and Google Scholar were searched for studies comparing ropivacaine versus levobupivacaine for labor analgesia. Maternal and fetal outcomes were considered as the endpoints in this analysis. The RevMan software 5.4 was used to analyze data in this study. Risk ratio (RR) with 95% confidence intervals (CI) were used to represent the data post analysis.</p><p><strong>Results: </strong>A total number of 2062 participants were included in this analysis whereby 1054 participants were assigned to ropivacaine and 1008 participants were assigned to levobupivacaine. The main results of this analysis showed that epidural ropivacaine was not associated with significantly higher risk of hypotension (RR: 0.71, 95% CI: 0.43 - 1.17; P = 0.18) and pruritus (RR: 1.12, 95% CI: 0.89 - 1.42; P = 0.34) when compared to levobupivacaine for labor analgesia. However, the risk of nausea and vomiting was significantly higher with ropivacaine (RR: 1.60, 95% CI: 1.05 - 2.44; P = 0.03). Spontaneous vaginal delivery (RR: 0.99, 95% CI: 0.89 - 1.42; P = 0.83), instrumental vaginal delivery (RR: 1.13, 95% CI: 0.89 - 1.45; P = 0.32) and the risk for cesarean section (RR: 0.76, 95% CI: 0.42 - 1.37; P = 0.35) were not significantly different. When fetal outcomes were assessed, Apgar score < 7 at 1 min (RR: 1.01: 95% CI: 0.57 - 1.80; P = 0.97), abnormality of fetal heart rate (RR: 1.45, 95% CI: 0.55 - 3.79; P = 0.45) and neonatal asphyxia (RR: 0.35, 95% CI: 0.10 - 1.18; P = 0.09) were also similarly manifested.</p><p><strong>Conclusions: </strong>To conclude, our analysis showed both epidural ropivacaine and levobupivacaine to be equally effective for labor analgesia in terms of maternal and fetal outcomes. No major adverse maternal and fetal outcome was observed in this analysis. However, considering the several limitations of this analysis, further larger studies should be able to solve and clarify this issue.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"378"},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory assessment of intramuscular quadratus lumborum block at the L2 level in open inguinal hernia repair patients.","authors":"Sainan Zhang, Jiaying Sun, Chufan Liu, Xinlian Gong, Ruoxing Chen, Zhousheng Jin, Fangfang Xia, Le Liu, Quanguang Wang, Hongfei Chen","doi":"10.1186/s12871-024-02763-8","DOIUrl":"10.1186/s12871-024-02763-8","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of the quadratus lumborum block (QLB) for postoperative pain management depends on the injection pathway used. There is limited research on the block area produced by intramuscular injection of local anesthesia in the quadratus lumborum muscle. This study aimed to determine the cutaneous sensory blockade area produced by an intramuscular quadratus lumborum block (QLBi) at the L2 level.</p><p><strong>Methods: </strong>Twenty patients aged 18-60 years with ASA grade I-II and a BMI of 18-30 kg/m² who were scheduled for open inguinal hernia repair with mesh underwent ultrasound-guided QLBi injection of 20 ml of 0.5% ropivacaine. The cutaneous sensory blockade area was measured by applying a cold stimulus 1 h after the block and then measured every hour after surgery until the sensation returned to normal. The duration of a blockade is defined as the time it takes for all affected areas to fully regain normal sensation following a blockade. Pain scores (numeric rating scale, NRS) were recorded at 2, 4, 8, 12, and 24 h after surgery. Adverse reactions to QLBi were recorded 24 h after surgery.</p><p><strong>Results: </strong>All 20 patients had reduced or lost cold sensation areas. The greatest extent of cold sensation reduction occurred at T7 (10%), and the least amount of cold sensation reduction occurred at L3 (10%). The block level covered T8 (20%), T9 (30%), T10 (45%), T11 (90%), T12 (95%), L1 (100%), and L2 (15%). Eighteen patients experienced areas of sensory loss, with the highest range at T11 and the lowest at L2. The duration of the blockade was 8.9 ± 3.8 h, with a maximum of 24 h and a minimum of 5 h. One patient experienced quadriceps weakness after surgery.</p><p><strong>Conclusion: </strong>Quadratus lumborum block of intramuscular pathway can produce effective cutaneous sensory blockade, which can be used for postoperative analgesia of indirect inguinal hernia operation, and may also be beneficial to analgesia of other lower abdominal operations. However, the best method needs further confirmation to determine specific anesthesia methods for various operations.</p><p><strong>Chinese clinical trial registry: </strong>June 2, 2018; ChiCTR1800016457.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"377"},"PeriodicalIF":2.3,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Startle sign events induced by mechanical manipulation during surgery for neuroma localization: a retrospective cohort study.","authors":"Jonathan M Gorky, Sarah J Karinja, Sylvia L Ranjeva, Lingshan Liu, Matthew R Smith, Ariel L Mueller, Timothy T Houle, Kyle R Eberlin, Katarina J Ruscic","doi":"10.1186/s12871-024-02758-5","DOIUrl":"10.1186/s12871-024-02758-5","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain from peripheral neuromas is difficult to manage and often requires surgical excision, though intraoperative identification of neuromas can be challenging due to anatomical ambiguity. Mechanical manipulation of the neuroma during surgery can elicit a characteristic \"startle sign\", which can help guide surgical management. However, it is unknown how anesthetic management affects detection of the startle sign.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of 73 neuroma excision surgeries performed recently at Massachusetts General Hospital. Physiological changes in the anesthetic record were analyzed to identify associations with a startle sign event. Anesthesia type and doses of pharmacological agents were analyzed between startle sign and no-startle sign groups.</p><p><strong>Results: </strong>Of the 64 neuroma resection surgeries included, 13 had a startle sign. Combined intravenous and inhalation anesthesia (CIVIA) was more frequently used in the startle sign group vs. no-startle sign group (54% vs. 8%), while regional blockade with monitored anesthetic care was not associated with the startle sign group (12% vs. 0%), p = 0.001 for anesthesia type. Other factors, such as neuromuscular blocking agents, ketamine infusion, remifentanil infusion, and intravenous morphine equivalents showed no differences between groups.</p><p><strong>Conclusions: </strong>Here, we identified hypothesis-generating descriptive differences in anesthetic management associated with the detection of the neuroma startle sign during neuroma excision surgery, suggesting ways to deliver anesthesia facilitating detection of this phenomenon. Prospective trials are needed to further validate the hypotheses generated.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"376"},"PeriodicalIF":2.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right-to-left-shunts in patients scheduled for neurosurgical intervention in semi-sitting position - a literature review based on two case scenarios.","authors":"Marina Nikolic, C Eisner, J O Neumann, D Haux, S M Krieg, M O Wielpütz, M A Weigand, U Tochtermann, Dania Fischer","doi":"10.1186/s12871-024-02757-6","DOIUrl":"10.1186/s12871-024-02757-6","url":null,"abstract":"<p><strong>Background: </strong>Neurosurgery performed in the semi-sitting position provides advantages for certain procedures. However, this approach is associated with potential complications, particularly venous air embolism. Due to typically negative venous pressure at the wound site, air can be drawn into the veins. This risk is especially high in patients presenting with an intra- or extracardiac right-to-left-shunt. Transoesophageal echocardiography can be used to detect a patent foramen ovale or other possible pulmonary-systemic shunt before placing the patient in the sitting position.</p><p><strong>Case presentation: </strong>In this report, we present two young patients undergoing scheduled microsurgical vestibular schwannoma removal in a semi-sitting position who were diagnosed with congenital heart defects during routine perioperative assessment to detect possible intracardiac right-to-left shunts, using pre- and intraoperative transesophageal echocardiography (TEE) and additionally conducting an agitated saline bubble study under Valsalva manoeuvre. Patient A was diagnosed with a persistent left superior vena cava and Patient B with an unroofed coronary sinus (UCS). These findings confronted the anesthesiological and surgical teams with difficult individual decisions regarding further perioperative management.</p><p><strong>Conclusions: </strong>Perioperative transesophageal echocardiography is a diagnostic tool to both detect intraoperative position-related air embolisms and to rule out intracardiac right-to-left shunts, e.g. a patent foramen ovale, in order to decide for or against a (semi-)sitting position. Depending on the surgical circumstances a semi-sitting positioning of patients presenting with an intracardiac right-to-left-shunt, e.g. a PFO, can be feasible in individual cases if there is an implemented therapeutic algorithm to immediately terminate significant venous air entry. However, since certain other intra- or extracardiac right-to-left-shunts, such as here presented PLSVC or UCS, are rare, there is no definitive way of estimating the amount of entered air through detected shunts or anomalous vessels. Therefore, it is recommended to avoid a (semi-)sitting position in favour of a lateral or prone position for a patient undergoing intracranial surgery, once the perioperative TEE shows air bubbles in the left atrium or ventricle whose origins cannot be defined solely through TEE for certain in order to ensure patient safety by minimizing the risk of intraoperative paradoxical air embolisms.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"375"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroencephalographic depression after abruptly increasing partial pressure of end-tidal carbon dioxide: a case series.","authors":"Shikuo Li, Yuyi Zhao, Qifeng Wang, Xuehan Li, Chao Chen, Yunxia Zuo","doi":"10.1186/s12871-024-02764-7","DOIUrl":"10.1186/s12871-024-02764-7","url":null,"abstract":"<p><strong>Background: </strong>Prolonged electroencephalographic depression during surgery is associated with poor outcomes for patients. However, the published literature on electroencephalographic depression caused by a sudden increase in the partial pressure of end-tidal carbon dioxide (P_ETCO₂) is lacking.</p><p><strong>Case presentation: </strong>We report four patients who were scheduled for laparoscopic liver surgery under general anesthesia. During the process of EEG monitoring with Sedline, four patients experienced electroencephalographic depression closely after a sudden increase in P_ETCO₂. The four patients showed that electroencephalographic depression mainly manifested as a slow in EEG frequency, a reduction in the amplitude and power of EEG, and a decrease in spectral edge frequency. Patient state index was elevated in three cases.</p><p><strong>Conclusions: </strong>To summarize, our patients showed EEG depression when P_ETCO₂ suddenly increased, which suggests that clinical doctors should be alert to electroencephalographic depression when the P_ETCO₂ abruptly increases. EEG monitoring devices should be applied in patients with possible hypercapnia. Anesthesiologists must comprehensively interpret the raw EEG, spectral edge frequency, and density spectral array data, in addition to patient sedation index values.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"373"},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of ultrasound-guided erector spinae plane block versus wound infiltration for postoperative analgesia in instrumented lumbar spinal surgeries.","authors":"Yucel Yuce, Secil Azime Karakus, Tahsin Simsek, Ceren Onal, Ozlem Sezen, Banu Cevik, Evren Aydogmus","doi":"10.1186/s12871-024-02754-9","DOIUrl":"10.1186/s12871-024-02754-9","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the efficacy of ultrasound-guided erector spinae plane block (ESPB) and wound infiltration (WI) for postoperative analgesia in patients who underwent lumbar spinal surgery with instrumentation.</p><p><strong>Methods: </strong>In this randomized controlled trial, 80 patients were divided into two groups: ESPB (n = 40) and WI (n = 40). Postoperative pain intensity was assessed via the visual analog scale (VAS) at multiple time points within 24 h. Additionally, opioid consumption, time to first rescue analgesia, incidence of postoperative nausea and vomiting (PONV), and patient satisfaction were evaluated.</p><p><strong>Results: </strong>Both ESPB and WI provided effective postoperative pain management, with no significant differences in VAS scores. However, the ESPB group demonstrated a significantly longer duration of analgesia, a shorter time to first rescue analgesia, and lower total tramadol consumption (50 ± 60 mg vs. 100 ± 75 mg; p = 0.010) than did the WI group. Furthermore, a trend toward reduced PONV incidence was observed in the ESPB group, likely due to its opioid-sparing effect.</p><p><strong>Conclusion: </strong>While both ESPB and WI provided effective postoperative pain management, ESPB demonstrated a distinct advantage by offering a longer duration of analgesia and significantly reducing opioid consumption. These findings suggest that ESPB is more effective than WI for postoperative analgesia in lumbar spinal surgeries, providing prolonged pain relief and improving patient outcomes. Further studies are warranted to explore its long-term benefits and cost-effectiveness.</p><p><strong>Trial registration: </strong>ClinicalTrials.govPRS: NCT06567964 Date: 08/21/2024 Retrospectively registered.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"374"},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients.","authors":"Xizhong Ma, Xueli Zhao, Ruina Guo, Zhixun Hu, Jianghong Liu, Hongfeng Nie","doi":"10.1186/s12871-024-02762-9","DOIUrl":"10.1186/s12871-024-02762-9","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this research was to evaluate the efficacy of Narcotrend (NT) monitoring on cognitive dysfunction in patients undergoing anesthesia blockade for gastrointestinal tumors and its effect on cerebral oxygen metabolism and inflammatory response.</p><p><strong>Methods: </strong>Patients preparing to undergo resection of gastrointestinal tumor resection were included and randomly divided into a control group (depth of anesthesia assessed by physician experience) and a research group (depth of anesthesia monitored by NT). HR and MAP were monitored at the preoperatively (T₀), 12 h postoperative (T₁), 24 h postoperative (T₂), and 48 h postoperative (T₃) stages. MMSE score was recorded to assess changes in cognitive function. Intracerebral oxygenation indicators (CjvO₂, CERO_2, and rSO₂) were assessed by a blood gas analyzer. ELISA assay was conducted to explore the serum inflammatory indexes (CRP, IL-1β, and TNF-α) and neurological function indicators (NSE and MBP).</p><p><strong>Results: </strong>MAP was higher in the research group than in the control group at T₁ and T₂ (P < 0.05). MMSE scores at T1, T2, and T3 stages were higher in the research group than in the control (P < 0.05). The incidence of POCD was also lower in the research group compared with the control (P < 0.05). CjvO₂, CERO_2, and rSO₂ were significantly higher (P < 0.05) and were positively correlated with the MMSE scores. Postoperative serum inflammatory indexes were significantly elevated in both groups, but more significantly in the control group (P < 0.05). Both neurological function indicators were usually reduced after surgery, but the reduction was more significant in the research group (P < 0.05).</p><p><strong>Conclusion: </strong>NT monitoring of anesthetic depth has a less physical impact on patients with gastrointestinal tumor anesthetic block, reduces the degree of postoperative POCD, and has significant clinical value.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"371"},"PeriodicalIF":2.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral erector spinae plane block by multiple injection for pain control in pseudomyxoma peritonei surgery: a single-blind randomized controlled trial.","authors":"Shuang Yu, Guangya Gao, Ruiqing Ma, Liangyuan Lu, Yaoping Zhao, Zhanmin Yang","doi":"10.1186/s12871-024-02749-6","DOIUrl":"10.1186/s12871-024-02749-6","url":null,"abstract":"<p><strong>Objective: </strong>Currently, the primary surgical treatment for pseudomyxoma peritonei (PMP) is cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC). The perioperative period is frequently accompanied by severe pain. Erector spinae plane block (ESPB) can enhance analgesia for abdominal surgery. The purpose of this study was to compare the analgesic effects of bilateral multiple-injection ESPB in patients with PMP.</p><p><strong>Methods: </strong>Fifty patients with PMP were randomly divided into two groups: the ESPB combined with general anesthesia group (Group E) and the general anesthesia alone group (Group C). Prior to the induction, patients in Group E underwent ESPB at the T7 and T11 levels. The primary outcome was the visual analog scale (VAS) scores during rest at 6 h post-extubation. Secondary outcomes included intraoperative and postoperative opioid consumption, time for first rescue analgesia, frequency distribution of rescue analgesia, incidence of nausea and vomiting, adverse events associated with ESPB.</p><p><strong>Results: </strong>The Visual Analogue Scale (VAS) scores in Group E were significantly lower compared to Group C at immediate post-extubation (1.6 ± 0.9 vs. 2.4 ± 1.2, P = 0.008), and at 2 (1.9 ± 1.2 vs. 3.2 ± 1.1, P < 0.001), 4 (2.4 ± 1.5 vs. 3.7 ± 1.0, P = 0.001), and 6 h (2.7 ± 1.1 vs. 3.8 ± 1.4, P = 0.004) post-extubation during rest. Similarly, the VAS scores in Group E were significantly lower than those in Group C at immediate post-extubation (3.0 ± 1.4 vs. 4.6 ± 1.2, P < 0.001), and at 2 (3.8 ± 1.7 vs. 4.9 ± 1.4, P = 0.019), 4 (3.5 ± 1.3 vs. 5.3 ± 1.5, P < 0.001), and 6 h (3.9 ± 1.8 vs. 4.9 ± 1.3, P = 0.004) post-extubation during movement. In Group E, the intraoperative remifentanil administration (2319.3 ± 1089.5 vs. 2984.6 ± 796.1, P = 0.017) and the amount of rescue analgesia within 2 h post-extubation (0 vs. 4, P = 0.037) were significantly less than in Group C, and the first rescue analgesia time was shorter as well (231.4 ± 147.5 vs. 668.8 ± 416.7, P < 0.001).</p><p><strong>Conclusion: </strong>Compared to general anesthesia alone, bilateral multiple-injection ESPB with 0.2% ropivacaine can enhance analgesia and reduce opioid administration in patients with PMP. However, the duration of analgesia with ESPB is relatively short due to the low concentration of the local anesthetic used.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR2300069504, 20/03/2023.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"370"},"PeriodicalIF":2.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Preoperative electrocardiogram in prediction of 90-day postoperative mortality: retrospective cohort study.","authors":"Bronislav Čapek, Jan Václavík, Klára Benešová, Jiří Jarkovský","doi":"10.1186/s12871-024-02761-w","DOIUrl":"10.1186/s12871-024-02761-w","url":null,"abstract":"","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"24 1","pages":"372"},"PeriodicalIF":2.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}